Claremont Insurance Serviceshttp://www.claremontcompanies.com
Wed, 29 Jul 2015 17:43:42 +0000en-UShourly1http://wordpress.org/?v=4.2.3Carriers Accept Early Applications for Q4 Coveragehttp://www.claremontcompanies.com/carriers-accept-early-applications-for-dec-1-effective-dates/
http://www.claremontcompanies.com/carriers-accept-early-applications-for-dec-1-effective-dates/#commentsWed, 22 Jul 2015 07:24:16 +0000http://www.claremontcompanies.com/?p=6206Are you concerned about the number of renewals in Q4, and how to service your small groups with a December 1 effective date? …read more]]>Are you concerned about the number of renewals in Q4, and how to service your small groups with a December 1 effective date? Now there’s a solution for those groups that need to change carriers — you can submit small group applications early.

The market expects 2/3 of all groups renewing in Q4 to have a December 1 anniversary date. During this extremely busy time for carriers and others, consider submitting new group applications in advance to reduce your workload, minimize stress, and avoid Q4 processing delays.

For a list of carriers and their early submission policies and timelines, download our Q4 Carrier Deadlines guide. What’s more, you’ll want to take advantage of the most flexible carrier — Blue Shield (they’re accepting all Q4 applications now).

Don’t delay, start submitting your small group applications now!

]]>http://www.claremontcompanies.com/carriers-accept-early-applications-for-dec-1-effective-dates/feed/0Wage and Tax Reports Are Not Required with Applications for 10+ Eligible Employeeshttp://www.claremontcompanies.com/submission-guideline-changes-for-groups-with-10/
http://www.claremontcompanies.com/submission-guideline-changes-for-groups-with-10/#commentsTue, 21 Jul 2015 05:07:47 +0000http://www.claremontcompanies.com/?p=6179UnitedHealthcare announced they are no longer requiring employer groups with 10+ eligible employees to submit quarterly wage and tax reports (DE9C). What’s more, …read more]]>UnitedHealthcare announced they are no longer requiring employer groups with 10+ eligible employees to submit quarterly wage and tax reports (DE9C). What’s more, they will accept a signed participation certificate to confirm participation requirements are met.

Please note: these changes do not apply to employer groups with 1-9 eligible employees. Wage and tax reports will still be required.

The ACA provides that the amount of the tax credit depends in part on whether the individual has enrolled in a health plan through “an Exchange established by the State.” An IRS Rule allows individuals to be eligible for the tax credit if the individual enrolls in a health plan through an Exchange, regardless of whether the Exchange is established and operated by a State or the federal government. Petitioners challenged the IRS Rule in the case King v. Burwell.

Petitioners are four individuals who live in Virginia and they do not want to purchase a health plan. Virginia has a federal Exchange, therefore in their view, Virginia’s Exchange does not qualify as “an Exchange established by the State,” which means they should not receive any tax credits. If the petitioners do not receive any tax credits, the cost of buying a health plan would be more than eight percent of their income, which would exempt them from the Individual Mandate. Under the IRS Rule, however, petitioners would be eligible to receive tax credits. The tax credits would make the cost of buying a health plan less than eight percent of petitioners’ income, which would then subject them to the Individual Mandate. The question then presented to the Court was whether the ACA’s tax credits are available in states that have a federal Exchange.

The Opinion of the Court, delivered by Justice Roberts, was that “while the meaning of the phrase ‘an Exchange established by the State… may seem plain ‘when viewed in isolation,’ such a reading turns out to be ‘untenable in light of [the statute] as a whole.” The Court stated that Congress based the ACA on three major reforms: first, the guaranteed issue and community rating requirements; second, a requirement that individuals maintain health insurance coverage; and third, the tax credits. Together, these reforms “minimize… adverse selection and broaden the health insurance risk pool to include healthy individuals, which will lower health insurance premiums.” The Court determined that, “Congress made the guaranteed issue and community rating requirements applicable in every State in the Nation. But those requirements only work when combined with the coverage requirement and the tax credits. So it stands to reason that Congress meant for those provisions to apply in every state as well.”

The Court explained that, “under the petitioners’ reading… one of the Act’s three major reforms – the tax credits – would not apply. And a second major reform – the coverage requirement – would not apply in a meaningful way… The combination of no tax credits and an ineffective coverage requirement could well push a State’s individual insurance market into a death spiral… It is implausible that Congress meant the Act to operate in this manner.” Cleverly, Justice Roberts quoted the dissenting opinion in the first Supreme Court case challenging the ACA, “Without the federal subsidies… the exchanges would not operate as Congress intended and may not operate at all.” The Court concluded in this case that, “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”

Petitioners also claimed that, “Congress was not worried about the effects of withholding tax credits from States with Federal Exchanges because ‘Congress evidently believed it was offering states a deal they would not refuse.’” The Court stated that a section of the ACA “provides that, if a State elects not to establish an Exchange, the Secretary ‘shall… establish and operate such Exchange within the State.’” As such, “Contrary to petitioners’ argument, Congress did not believe it was offering States a deal they would not refuse – it expressly addressed what would happen if a State did refuse the deal.”

There’s another critical aspect to the Court’s decision. When a statute is ambiguous and the regulatory agency’s interpretation is reasonable, the Court defers to the agency’s interpretation. “This approach ‘is premised on the theory that a statute’s ambiguity constitutes an implicit delegation from Congress to the agency to fill in the statutory gaps.’” In this case, however, the Court found that Congress did not intend to delegate interpretive authority to the IRS on this issue. Therefore, it was instead the task of the Court to determine the correct reading of the statute. This is a critical aspect of the decision, because it would preclude a future administration from drafting differing regulation from the current interpretation.

The Urban Institute estimated that a victory for the petitioner “would increase the number of uninsured by 8.2 million people and eliminate $28.8 billion in tax credits and cost-sharing reductions in 2016 ($340 billion over 10 years) for 9.3 million people. With lower-cost individuals leaving the market, average non-group premiums in 34 states would increase by 35 percent, affecting those purchasing inside and outside those Marketplaces.” In addition, there would be an impact on the enforcement of the Large Employer Mandate, because an employee’s receipt of a tax credit triggers an employer’s penalty for non-compliance. These consequences, however, have been avoided because of the Supreme Court’s decision to uphold the availability of the ACA’s premium tax credits on federal Exchanges. This decision does not directly affect California, because California has a state-based Exchange.

]]>http://www.claremontcompanies.com/supreme-court-upholds-premium-tax-credits-on-the-federal-exchange-in-king-v-burwell-case/feed/0SB 125: Revises the Definition of Small Employerhttp://www.claremontcompanies.com/sb-125-revises-the-definition-of-small-employer/
http://www.claremontcompanies.com/sb-125-revises-the-definition-of-small-employer/#commentsMon, 06 Jul 2015 07:07:53 +0000http://www.claremontcompanies.com/?p=6150On June 17, the Governor approved Senate Bill (SB) 125. A section of SB 125 revises the definition of small employer for plan …read more]]>On June 17, the Governor approved Senate Bill (SB) 125. A section of SB 125 revises the definition of small employer for plan years commencing or renewing on or after January 1, 2016. The definition of small employer, for purposes of determining employer eligibility in the small group market, will no longer be based on a count of eligible employees, but shall instead be determined using the method for counting full-time employees and full-time equivalent employees set forth in Section 4980H(c)(2) of the Internal Revenue Code.

Employer size under Section 4980H(c)(2) of the Internal Revenue Code is determined by taking the sum of the total number of full-time employees and full-time equivalent employees for a calendar month. To be a small employer in California, the result must be at least one, but no more than 100, on at least 50 percent of the preceding calendar quarter or preceding calendar year. The majority of these employees must be employed within California. The requirement that a bona fide employer-employee relationship exists still applies.

A full-time employee is someone employed an average of at least 30 hours of service per week. To calculate full-time equivalent employees, the number of hours of service for a calendar month of all employees who are not full-time are aggregated then divided by 120. No more than 120 hours of service can be credited for any employee who is not full-time. Hours of service includes both working hours and non-working hours for which an employee is paid or entitled to be paid, such as vacation, holiday, illness, incapacity, jury duty, military duty, and leave of absence.

The regulations of Section 4980H(c)(2) specify to include seasonal workers when counting the number of full-time employees and calculating the number of full-time equivalents. A seasonal worker is someone who performs labor or services on a seasonal basis. This employment is only done during certain periods and not throughout the year, such as those who only work during the holidays. Someone who works in agriculture, but performs different activities in different seasons, is considered seasonal, even if they are employed most of the year. A reasonable, good faith interpretation of the term seasonal worker may be applied.

As described above, SB 125 will result in significant changes to the small group market. However, the practical administration of this law has yet to be determined. Stay tuned for updates on this topic.

]]>http://www.claremontcompanies.com/sb-125-revises-the-definition-of-small-employer/feed/0Get Large Group Benefits and Pricing for Your Small Groupshttp://www.claremontcompanies.com/acec-lifehealth-trust-by-unitedhealthcare/
http://www.claremontcompanies.com/acec-lifehealth-trust-by-unitedhealthcare/#commentsFri, 12 Jun 2015 00:06:24 +0000http://www.claremontcompanies.com/?p=6141Your small engineering groups (2-100 lives) can access the same benefits and pricing as large employers with UnitedHealthcare’s ACEC Life/Health Trust. What’s more, …read more]]>Your small engineering groups (2-100 lives) can access the same benefits and pricing as large employers with UnitedHealthcare’s ACEC Life/Health Trust. What’s more, there’s much less impact from the ACA to large group plans versus small group plans.

Designed exclusively for American Council of Engineering Companies (ACEC) members, the ACEC Life/Health Trust offers large group medical, dental, vision, life and disability insurance benefits typically only available to large employers.

Please note: the ACEC Life/Health Trust agent/broker of record process is the same as with UnitedHealthcare. Your ACEC sales apply towards the UnitedHealthcare Broker Bonus and your United Advantage Status (Platinum, Gold and Silver).

Gain new business by offering your small engineering groups the same benefits and pricing typically only available to large groups with UnitedHealthcare’s ACEC Life/Health Trust.

]]>http://www.claremontcompanies.com/acec-lifehealth-trust-by-unitedhealthcare/feed/0Pediatric Dental Flexibility and Savingshttp://www.claremontcompanies.com/covered-california-pediatric-dental-2016/
http://www.claremontcompanies.com/covered-california-pediatric-dental-2016/#commentsFri, 12 Jun 2015 00:07:40 +0000http://www.claremontcompanies.com/?p=6140Many employers are looking for flexible affordable health care solutions that provide the opportunity to choose whether or not to offer pediatric dental …read more]]>Many employers are looking for flexible affordable health care solutions that provide the opportunity to choose whether or not to offer pediatric dental benefits. Covered California for Small business does not require pediatric dental to be included in their plans – a unique advantage that allows your employers the option to decide if pediatric dental is necessary, and if not, reduces the cost of plans for those that don’t need it.

Offer your employers these unique advantages:

No pediatric dental requirement. (Plans sold by carriers directly or through another exchange are required by the ACA to embed pediatric dental coverage.)

Flexibility to decide if pediatric dental is necessary.

Reduced costs for plans that do not include pediatric dental.

In 2016, carriers will continue to have the choice not to include pediatric dental.

Currently Blue Shield, Kaiser and Health Net do not include pediatric dental in their Covered California for Small Business plans.

Don’t miss this opportunity to provide flexibility on pediatric dental benefits, and the associated cost savings, available only through Covered California for Small Business.

]]>http://www.claremontcompanies.com/covered-california-pediatric-dental-2016/feed/0UnitedHealthcare Q4 2015 Small Group Rate Passhttp://www.claremontcompanies.com/unitedhealthcare-q4-2015-small-group-rate-pass/
http://www.claremontcompanies.com/unitedhealthcare-q4-2015-small-group-rate-pass/#commentsThu, 11 Jun 2015 23:05:42 +0000http://www.claremontcompanies.com/?p=6139UnitedHealthcare has announced a Q4 2015 rate pass for small group PPO plans, with no benefit changes. HMO plans will increase an average …read more]]>UnitedHealthcare has announced a Q4 2015 rate pass for small group PPO plans, with no benefit changes. HMO plans will increase an average of 2.5%.

UnitedHealthcare is offering a bonus to California agents who sell new medical groups with up to 99 eligible employees from July 1, 2015 through September 30, 2015. To qualify, agents must sell a total of at least 25 enrolled employees and have a net change percentage of at least 100% during the bonus period.

Learn how you can earn a bonus of up to $100 for each enrolled employee in eligible new cases.Get the details.

Need renewal assistance?Our team of experts is ready to help you find the best plan options for your Blue Shield renewals. Simply send your group’s Member-Level Census, along with a completed Quote Request Form to quotes@claremontcompanies.com or call 800.696.4543.

]]>http://www.claremontcompanies.com/save-time-quoting-your-blue-shield-small-group-renewals/feed/0Grandmothered Plans Will Be Withdrawn This Yearhttp://www.claremontcompanies.com/grandmothered-plans-will-be-withdrawn-this-year/
http://www.claremontcompanies.com/grandmothered-plans-will-be-withdrawn-this-year/#commentsMon, 06 Jul 2015 07:42:47 +0000http://www.claremontcompanies.com/?p=6151Grandmothered plans will no longer be available after December, and all groups must transition to an ACA-compliant plan. Notification will be provided 90-days …read more]]>Grandmothered plans will no longer be available after December, and all groups must transition to an ACA-compliant plan. Notification will be provided 90-days prior to your group’s 4th quarter anniversary date, along with information about their upcoming renewal kits. Withdrawal notifications from Blue Shield have been sent to your October renewing groups. November and December 90-day notifications will follow.

Advise your groups about the withdrawal of their grandmothered plans, and help them select and transition to new ACA compliant plans effortlessly.

Need assistance?Our team of experts is ready to help you find the best ACA compliant plans for your Blue Shield renewals. Simply contact us at 800.696.4543 or info@claremontcompanies.com.

]]>http://www.claremontcompanies.com/grandmothered-plans-will-be-withdrawn-this-year/feed/0Small Groups Transition to OneSpot from Employer Connection Plushttp://www.claremontcompanies.com/small-groups-transition-to-onespot-from-employer-connection-plus/
http://www.claremontcompanies.com/small-groups-transition-to-onespot-from-employer-connection-plus/#commentsMon, 06 Jul 2015 09:11:06 +0000http://www.claremontcompanies.com/?p=6155In August, Blue Shield of California will begin transitioning Small Business groups to OneSpot from Employer Connection Plus (EC+) to help you quickly …read more]]>In August, Blue Shield of California will begin transitioning Small Business groups to OneSpot from Employer Connection Plus (EC+) to help you quickly and easily manage your benefit plans online. The migration will be done in waves based on a group’s effective date, concluding in the first quarter of 2016.

Register for live instructor-led webinars held every Monday and Tuesday.

View training videos.

Get user guides, tools and FAQs.

To access OneSpot go toBlueShieldCA.com/producer. (Log-in instructions.)
Please note: OneSpot is only available for groups that have completed the transition from Employer Connection Plus. Blue Shield will notify you approximately 60 days in advance of the transfer.

]]>http://www.claremontcompanies.com/small-groups-transition-to-onespot-from-employer-connection-plus/feed/0Win FREE Telemarketing from Covered California for Small Businesshttp://www.claremontcompanies.com/win-free-telemarketing-from-covered-california-for-small-business/
http://www.claremontcompanies.com/win-free-telemarketing-from-covered-california-for-small-business/#commentsWed, 06 May 2015 04:44:57 +0000http://www.claremontcompanies.com/?p=5996Certified Insurance Agents selling the most lives on Covered for Small Business each month will win 100 hours of FREE telemarketing ($2,800 estimated …read more]]>Certified Insurance Agents selling the most lives on Covered for Small Business each month will win 100 hours of FREE telemarketing ($2,800 estimated value). For June through August 2015 effective dates.

The Broker Service Representative II (BSR) is a member of a team responsible for cultivating and maintaining quality relationships with both, brokers and …read more]]>

Summary:

The Broker Service Representative II (BSR) is a member of a team responsible for cultivating and maintaining quality relationships with both, brokers and carriers. The BSR works with sales team members, including Sales Representatives and Account Managers, on a case-by-case basis to match brokers’ and customers’ needs with the right product offering and to deliver a high level of service. The BSR is regularly required to analyze, compare, confer, communicate, coordinate, make decisions, monitor, motivate, organize, persuade, question, research, review, recommend and report.

Essential Duties and Responsibilities:

Expectations of a BSR may include any of the following:

Create and maintain effective customer relationships.

Provide timely, accurate responses to all inquiries from brokers that are made by phone, email or fax in a prompt and courteous manner.

Consult and problem-solve for broker customers to ensure best outcomes.

Communicate with brokers and/or carriers on pertinent matters in a timely and complete manner.

Manage expectations of brokers and fellow team members.

Provide product and market information to brokers and team members with appropriate medium.

Monitor service commitment and progress tracking systems and reports, such as quote queue, application processing tracking reports, and satisfaction surveys to ensure Claremont’s service commitment is met.

Deliver broker services as defined by management including, but not limited to:the review, completion, correction and submittal of applications, and provide for or answer questions related requirements of carrier or administrator

]]>http://www.claremontcompanies.com/broker-services-rep-ii/feed/0SVAHU April 23 Event Summary: “Transformational Innovation in Our Market” with Zenefits CEO Parker Conradhttp://www.claremontcompanies.com/event-summary-transformational-innovation-in-our-market-with-zenefits-ceo-parker-conrad/
http://www.claremontcompanies.com/event-summary-transformational-innovation-in-our-market-with-zenefits-ceo-parker-conrad/#commentsTue, 28 Apr 2015 22:26:39 +0000http://www.claremontcompanies.com/?p=5980For brokers and agents who were unable to attend the sold out Silicon Valley Association of Health Underwriters (SVAHU) April 23 event, below …read more]]>For brokers and agents who were unable to attend the sold out Silicon Valley Association of Health Underwriters (SVAHU) April 23 event, below is our summary of the key messages with links to additional content. The guest speakers and topics included:

Key Takeaways:

At $18 billion, the benefits market continues to evolve and grow, and will continue to be an attractive space for new entrants. There is also plenty of opportunity for seasoned brokers who understand and can satisfy customer needs.

Employers want a complete and easy solution to their HR/Benefits/Payroll compliance burden, allowing them to focus on what they do best: running their business.

Brokers and agents will need to determine how to evolve their services to meet client needs, with the help of partners like software vendors and general agents.

Brokers need to take off their “benefits goggles” and understand that the issue is not about technology; it’s about giving the employer a “worry free” solution to benefits administration.

The convergence of 3 market conditions are creating the perfect storm for this market demand:

New laws and benefits – ACA mandates require more employers to track qualified employees, and offer appropriate coverage. These tedious and complicated tasks can best be managed with software.

Changing workforce and work environment – increasing numbers of remote employees who rely on their intranet and mobile tools everyday for work, plus a younger workforce that embraces mobile technology as part of their lifestyle.

New technologies – the proliferation of mobile and tablet devices for both professional and personal use is enabling a workforce that expects to engage with content in a mobile and on-demand way.

The HR/Benefits market segment is attracting a variety of new entrants:

The HR technology market is valued at more than $15 billion, attracting more than 100 new start-ups and counting.

Industry giants like ADP are investing R&D dollars in software, and software giants like Workday are entering into the benefits industry.

What employers want in a HR/Benefits solution:

86% of businesses are looking for a system with HR/Benefits or HR/Benefits/Payroll in one.

They want to access the data anytime, anywhere – on any device, and allow their employees to access on any device too.

Employers want a solution that doesn’t require them to figure out how to use the various tools. Employers want an answer to their HR and benefits burden that’s effortless and reliable.

At a minimum, brokers should develop the ability to understand and recommend technology based on client needs.

HR and benefits technologies are evolving quickly, but at this point “none provides a silver bullet” for small employers needs.

The answer must be mobile:

80% of employees will not use their benefits beyond an office visit copay or prescription drug

60% of employees don’t have internet access or email from work

75% of working people have a smart phone

Software platforms provide transactional value. Brokers can augment the employer’s software with more strategic value including benefits admin support and consulting.

Any broker can develop a benefits enrollment solution, but only 10% of the employer market wants a benefits-only solution. Benefits-only solutions won’t help the broker differentiate, or even compete against organizations like Zenefits.

For a rich digest of the interview and commentary from Michael Lujan, visit Michael’s LinkedIn post. Here are the highlights:

Zenefits’ Product Description:

Conrad describes Zenefits’ product as “an integrated system of record for employee information.” When asked if they are a technology company or a benefits broker, he said they are both. They train their salespeople to be competent on selling benefits and selling software.

Employers can use all of their software without having to make Zenefits their broker. But if the group wants to link up their insurance info into those systems, they do have to sign over BOR. Parker says they do not have a BOR acquisition campaign, but employers can’t realize the full value of the software unless they sign over the benefits administration and BOR.

Zenefits’ Sales and Marketing:

Zenefits is a sales and marketing machine. They have invested tremendous resources in new business acquisition and provocative marketing messages that have lowered the switching costs to employers. They’re adding 500 new groups per month nationwide, with an average 15-30 day sales cycle from demo to close.

Zenefits leads their prospecting calls with why Zenefits is a better broker than the employer’s current broker, and why their technology supports that value proposition. Conrad claims Zenefits is a better broker because they deliver a solution to the employer that is easy and requires little effort on the employer’s part. This is especially compelling to small employers who have few or no HR resources, and therefore the HR function falls to leadership.

Zenefits has been most successful in small groups: their average group size is 16 subscribers, and their sweet spot is groups with 20-150 employees. They are beginning to gain traction with large (500+ employee) groups as well.

]]>http://www.claremontcompanies.com/event-summary-transformational-innovation-in-our-market-with-zenefits-ceo-parker-conrad/feed/0New Covered California Branding and Advertising Campaigns For SHOPhttp://www.claremontcompanies.com/covered-california-launches-new-branding-and-advertising-for-shop/
http://www.claremontcompanies.com/covered-california-launches-new-branding-and-advertising-for-shop/#commentsThu, 23 Apr 2015 01:26:25 +0000http://www.claremontcompanies.com/?p=5973To promote awareness among small business owners and generate more business for Certified Insurance Agents, Covered California for Small Business, SHOP’s new name, …read more]]>To promote awareness among small business owners and generate more business for Certified Insurance Agents, Covered California for Small Business, SHOP’s new name, will roll out a series of new advertising campaigns featuring their quality, affordable employee health benefits.

The name has changed, but the same great health plans and offerings are available, including:

]]>http://www.claremontcompanies.com/covered-california-launches-new-branding-and-advertising-for-shop/feed/0Prescription Drug Benefits – Simple Guides For Your Small Business Groupshttp://www.claremontcompanies.com/prescription-drug-benefits-simple-guides-for-your-small-business-groups/
http://www.claremontcompanies.com/prescription-drug-benefits-simple-guides-for-your-small-business-groups/#commentsThu, 23 Apr 2015 00:13:52 +0000http://www.claremontcompanies.com/?p=5971Are you getting more questions from your small business prospects and clients about their prescription drug benefits?

]]>http://www.claremontcompanies.com/prescription-drug-benefits-simple-guides-for-your-small-business-groups/feed/0WEBI Charity Golf Tournament June 15http://www.claremontcompanies.com/webi-golf-tournament-june15/
http://www.claremontcompanies.com/webi-golf-tournament-june15/#commentsThu, 09 Apr 2015 15:55:46 +0000http://www.claremontcompanies.com/?p=5954Join us for a fun-filled day of golf and networking at the 24th annual Women in Employee Benefits Invitational (WEBI) charity golf tournament …read more]]>Join us for a fun-filled day of golf and networking at the 24th annual Women in Employee Benefits Invitational (WEBI) charity golf tournament benefiting The Cancer Prevention Institute of California (CPIC). Sign up to play golf or simply attend the festivities! Learn more.

]]>http://www.claremontcompanies.com/covered-california-launches-a-new-learning-management-system-lms/feed/0UnitedHealthcare Q3 2015 Small Group Plan Rate Passhttp://www.claremontcompanies.com/unitedhealthcare-q3-2015-small-group-plan-rate-pass/
http://www.claremontcompanies.com/unitedhealthcare-q3-2015-small-group-plan-rate-pass/#commentsThu, 09 Apr 2015 00:18:25 +0000http://www.claremontcompanies.com/?p=5949UnitedHealthcare’s current portfolio and packages will remain unchanged through September. There will be no plan or benefit changes for Q3 from the plans …read more]]>UnitedHealthcare’s current portfolio and packages will remain unchanged through September. There will be no plan or benefit changes for Q3 from the plans and rates released effective April 1, 2015.

]]>http://www.claremontcompanies.com/unitedhealthcare-q3-2015-small-group-plan-rate-pass/feed/0The Top 20 Lowest Cost ACA Plans – Small Grouphttp://www.claremontcompanies.com/the-top-20-lowest-cost-aca-plans-small-group/
http://www.claremontcompanies.com/the-top-20-lowest-cost-aca-plans-small-group/#commentsWed, 08 Apr 2015 03:11:48 +0000http://www.claremontcompanies.com/?p=5945Healthcare reform forced the standardization of medical plan design for transparent cost comparison. In 2015, all small group medical plans must comply with …read more]]>Healthcare reform forced the standardization of medical plan design for transparent cost comparison. In 2015, all small group medical plans must comply with the metal tier leveling by actuarial value, and 19 rating region distribution for California. Based on these criteria, we’ve developed a report for you to see the most cost effective plans by region.

The Top 20 Lowest Cost ACA Plans Report will support you to:

Drive your new business acquisition by offering prospects visible cost savings. Qualify a prospect’s willingness to purchase coverage by illustrating the lowest cost plans available in their region.

Bypass your competition with powerful market intelligence.

Sell Covered California/SHOP, since these plans rank highly in each region with multiple preferred carrier options.

The report has been updated with Q3 premiums for 2015. To easily compare the lowest cost ACA plans, download the free report that includes all 19 California regions. For a sample report of Region 1: 22 North State and Mid-Sierra Counties; and Region 2: Napa, Sonoma, Solano and Marin Counties, click the image below.

]]>http://www.claremontcompanies.com/the-top-20-lowest-cost-aca-plans-small-group/feed/0Prepare Now For Your Upcoming ACA Plan Renewalshttp://www.claremontcompanies.com/prepare-now-for-your-upcoming-aca-plan-renewals/
http://www.claremontcompanies.com/prepare-now-for-your-upcoming-aca-plan-renewals/#commentsTue, 07 Apr 2015 17:16:19 +0000http://www.claremontcompanies.com/?p=5943All California employers with small group coverage must be offered ACA compliant plans by the end of 2015. That equates to tens of …read more]]>All California employers with small group coverage must be offered ACA compliant plans by the end of 2015. That equates to tens of thousands of groups across the state all renewing at the same time.

To help you and your staff prepare and manage the large number of upcoming small group renewal quotes, you’ll want to follow these steps:

]]>http://www.claremontcompanies.com/aca-renewal-rate-explanation-health-insurance-only/feed/0Because They Said So, Impermissible Health Coverage Reimbursement Arrangementshttp://www.claremontcompanies.com/because-they-said-so-impermissible-health-coverage-reimbursement-arrangements/
http://www.claremontcompanies.com/because-they-said-so-impermissible-health-coverage-reimbursement-arrangements/#commentsTue, 07 Apr 2015 17:12:12 +0000http://www.claremontcompanies.com/?p=5941There is a critical topic being discussed in the world of employer-sponsored health coverage. It focuses on risky strategies some employers are taking …read more]]>There is a critical topic being discussed in the world of employer-sponsored health coverage. It focuses on risky strategies some employers are taking to provide employees with health coverage and how this is impermissible in the eyes of the Treasury Department and IRS, Department of Labor (DOL), and Health and Human Services (HHS) (collectively, the Departments).

The New York Times covered this topic last June in an article entitled “Risking a Health Insurance Strategy the I.R.S. May Not Approve.” The article discusses how certain companies, such as Zane Benefits and TASC, are offering employers what is known as a ‘defined contribution plan’ for their employees. The idea is that, rather than purchasing group coverage, an employer reimburses employees for the cost of purchasing individual health coverage. It can be designed to be tax-free for the employee and excluded from payroll taxes for the employer. The apparent appeal is the savings to the employer.

It may sound like a great solution, however, these arrangements generally are considered to be group health plans and will fail to comply with the market reforms that apply to group health plans under the Affordable Care Act (ACA). In a guidance issued in 2013, Notice 2013-54, the IRS explained why these arrangements fail to comply with ACA market reforms, specifically the annual dollar limit prohibition and the preventive services requirement. Under the annual dollar limit prohibition, a group health plan may not establish any annual limit on the dollar amount of essential health benefits. The preventive services requirement provides that non-grandfathered group health plans are required to provide certain preventive services without cost-sharing. Reimbursement arrangements, employer payment plans, and defined contribution reimbursement arrangements will fail to comply with the annual dollar limit prohibition, because these arrangements/plans are considered to impose an annual limit up to the cost of the individual market coverage purchased through the arrangement. These arrangements/plans will also fail to comply with the preventive services requirement, because they do not provide preventive services without cost-sharing in all instances.

Zane Benefits claims that the effect of Notice 2013-54 was to make it more cumbersome, but not impossible, for employers to give employees tax-free reimbursement of premiums for individual health insurance. Zane Benefits argues that health insurance premiums are not an essential health benefit under the ACA and thus an employer is not required to offer unlimited annual amounts for employees to purchase health insurance. Moreover, Zane Benefits asserts that the tax code has not changed. Health insurance premiums are medical care expenses under Code section 213(d)(1), and amounts received as reimbursement for these expenses can be excluded from the gross income of the employee under Code section 105.

Though Zane Benefits’ arguments may seem logical, the Departments clearly stated in Notice 2013-54 and reiterated in an FAQ, that these arrangements are impermissible when considering the application of ACA market reforms. Moreover, the intent of the ACA was to keep employer-sponsored coverage in place. It is important to note that these arrangements are themselves group health plans and, therefore, employees participating in such arrangements are ineligible for premium tax credits and cost-sharing reductions on the Exchange.

An employer that maintains an impermissible arrangement will be subject to an excise tax equal to $100 per day or $36,500 a year per affected beneficiary. There is a cap of $500,000 for non-willful violations, however employers may also be subject to lawsuits by affected participants and beneficiaries.

The Treasury Department and the IRS, in conjunction with DOL and HHS, continue to provide guidance on this issue and they anticipate that further clarifications on this issue will be provided in the near future. In a more recent guidance, Notice 2015-17, transition relief from the excise tax is provided to employers that are not Applicable Large Employers* in 2014 and 2015. The Departments understand that these employers may have been offering plans that pay or reimburse employees for individual health policy premiums or Medicare Part B or Part D premiums and therefore may need additional time to obtain group health coverage or adopt a suitable alternative. As such, these employers will not be subject to the excise tax for 2014 and for January 1 through June 30, 2015. After June 30, 2015, these employers may be liable for the excise tax if they do not come into compliance.

If your clients or prospects are at risk for impermissible arrangements, Claremont can design a compliant solution.
To learn more, contact your Claremont sales representative at 800.696.4543 or info@claremontcompanies.com.

Find out more about impermissible health coverage reimbursement arrangements here.

*Applicable Large Employers generally are employers that employed an average of at least 50 full-time employees (including full-time equivalents) in the prior calendar year.

]]>http://www.claremontcompanies.com/because-they-said-so-impermissible-health-coverage-reimbursement-arrangements/feed/0When Is An Employer’s First Year As An ALE?http://www.claremontcompanies.com/when-is-an-employers-first-year-as-an-ale/
http://www.claremontcompanies.com/when-is-an-employers-first-year-as-an-ale/#commentsTue, 07 Apr 2015 17:02:40 +0000http://www.claremontcompanies.com/?p=5939The final large employer mandate regulations provide for a transition rule for an employer’s first year as an applicable large employer (ALE). An …read more]]>The final large employer mandate regulations provide for a transition rule for an employer’s first year as an applicable large employer (ALE). An ALE is an employer that employed an average of at least 50 full-time (FT) and full-time equivalent (FTE) employees in the prior year. During an employer’s first year as an ALE, the ALE will not be subject to a penalty from January through March for failure to offer coverage to employees who were not offered coverage at any point during the prior calendar year provided the ALE offers affordable and minimum value coverage to these employees on or before April 1.

This transition rule allows employers, particularly employers that have close to 50* FT employees (including FTEs), but are not certain they will be ALEs, time to put coverage in place once they have determined they are ALEs. Since the measurement period to determine ALE status ends December 31**, employers will have no time to offer coverage to its employees by January 1. Starting coverage in the middle of the month to give employers time to put coverage in place is not an option, because an employer that fails to offer coverage to a FT employee for any day in a calendar month is treated as not offering coverage for the entire calendar month.

There has been some confusion among employers that want to take advantage of this transition rule in 2015 as to when is their first year as an ALE. In 2013, the IRS delayed the reporting requirements making it impractical to determine which employers owed a penalty. As such, no penalties were assessed in 2014. However, this had no effect on the effective date of the law, it was simply enforcement of the reporting requirements and penalties that were delayed. This means employers still needed to determine if they were an ALE in 2014. Therefore, 2015 is not the first year an employer is an ALE, if that employer was an ALE in 2014 (based on 2013 data).

It can be argued that the first year as an ALE for every employer with 100 FT employees (including FTEs) is 2015. Since no penalties were assessed in 2014, it can be claimed that employers were not required to comply with the provisions of the large employer mandate in 2014, including determination of ALE status. However, if this were the case, any employer with 100 FT employees (including FTEs) in 2015 could avoid penalties from January through March for failure to offer coverage to employees who were not offered coverage at any point during the prior calendar year. It is unlikely that this was the IRS’ intention. Moreover, the instructions for the reporting forms for ALEs (IRS Forms 1094-C and 1095-C) are clear that 2015 is not the first year an employer is an ALE, if that employer was an ALE in 2014 (based on 2013 data).

*Only employers with 100 or more FT employees (including FTEs) are subject to the mandate in 2015. Employers with 50-99 FT employees (including FTEs) will not be subject to the mandate in 2015 if these employers meet certain conditions and certify to the IRS that they meet these conditions. These ALEs will be subject to the mandate in 2016.

* *To determine ALE status for 2015, an employer may use a reference period of at least six consecutive calendar months (as chosen by the employer) during 2014 (rather than the entire 2014).

]]>http://www.claremontcompanies.com/when-is-an-employers-first-year-as-an-ale/feed/0How to Administer Group Enrollment Changes in SHOPhttp://www.claremontcompanies.com/how-to-administer-group-enrollment-changes-in-shop/
http://www.claremontcompanies.com/how-to-administer-group-enrollment-changes-in-shop/#commentsThu, 02 Apr 2015 16:19:41 +0000http://www.claremontcompanies.com/?p=5908Looking for help on how to administer group enrollment changes in Covered California SHOP? Check out our two recent Covered California FAQ’s:

Answers to other frequently asked ACA and Covered California broker questions can be found here.

Get the resources and expertise you need to enhance your SHOP sales efforts and grow your business. For more information or assistance, contact the experts at 800.696.4543 or info@claremontcompanies.com.

]]>http://www.claremontcompanies.com/how-to-administer-group-enrollment-changes-in-shop/feed/0Blue Shield Cal-COBRA Small Group Guidelineshttp://www.claremontcompanies.com/blue-shield-cal-cobra-small-group-guidelines/
http://www.claremontcompanies.com/blue-shield-cal-cobra-small-group-guidelines/#commentsThu, 02 Apr 2015 16:49:04 +0000http://www.claremontcompanies.com/?p=5910Are your Blue Shield small group clients subject to Cal-COBRA*? And if so, are they following the Blue Shield Cal-COBRA process required to …read more]]>Are your Blue Shield small group clients subject to Cal-COBRA*? And if so, are they following the Blue Shield Cal-COBRA process required to remain compliant? Stay up-to-date and properly advise your small group clients with Claremont’s Blue Shield Cal-COBRA Guide.

]]>http://www.claremontcompanies.com/blue-shield-cal-cobra-small-group-guidelines/feed/0Blue Shield Cal-COBRA Small Group Guidelineshttp://www.claremontcompanies.com/cal-cobra-small-group-employer-guidelines/
http://www.claremontcompanies.com/cal-cobra-small-group-employer-guidelines/#commentsThu, 02 Apr 2015 01:11:24 +0000http://www.claremontcompanies.com/?p=5905Are your Blue Shield small group clients subject to Cal-COBRA*? And if so, are they following the Blue Shield Cal-COBRA process required to …read more]]>Are your Blue Shield small group clients subject to Cal-COBRA*? And if so, are they following the Blue Shield Cal-COBRA process required to remain compliant? Stay up-to-date and properly advise your small group clients with Claremont’s Blue Shield Cal-COBRA Guide.

*CIA’s can earn a FREE 1,000 SHOPWorks postcard campaign with any new enrollments of 10+ with effective dates of April 1, May 1 or June 1 2015.

]]>http://www.claremontcompanies.com/shopworks-free-customizable-postcard-promotions/feed/0Experience Covered California SHOP Price Protectionhttp://www.claremontcompanies.com/experience-covered-california-shop-price-protection/
http://www.claremontcompanies.com/experience-covered-california-shop-price-protection/#commentsFri, 20 Mar 2015 19:53:14 +0000http://www.claremontcompanies.com/?p=5866By law, when identical plans are offered through SHOP, the carrier or another exchange, SHOP will always have the lowest cost. Your clients …read more]]>By law, when identical plans are offered through SHOP, the carrier or another exchange, SHOP will always have the lowest cost. Your clients will gain price protection and can achieve significant savings when you recommend SHOP. For example: rates for identical Health Net plans are as much as 11% higher outside of SHOP.

To gain a better understanding of SHOP’s unique features and how they benefit small business groups, here are three valuable sales guides:

Get the resources and expertise you need to enhance your SHOP sales efforts and grow your business. For more information or assistance, contact the experts at 800.696.4543 or info@claremontcompanies.com.

]]>http://www.claremontcompanies.com/experience-covered-california-shop-price-protection/feed/03 Steps to Protect Yourself from an Errors and Omissions Claimhttp://www.claremontcompanies.com/3-steps-to-protect-yourself-from-an-errors-and-omissions-claim/
http://www.claremontcompanies.com/3-steps-to-protect-yourself-from-an-errors-and-omissions-claim/#commentsFri, 20 Mar 2015 03:33:39 +0000http://www.claremontcompanies.com/?p=5846As brokers and agents, you are familiar with the provisions of ERISA, HIPAA and other long-standing regulations that affect your business. And you …read more]]>As brokers and agents, you are familiar with the provisions of ERISA, HIPAA and other long-standing regulations that affect your business. And you have purchased errors and omissions (E&O) coverage to protect yourself and your business, should a claim be brought against you. It’s not as uncommon as you would think. According to Insurance Business America, one in seven agents (15%) can expect to incur an E&O claim or lawsuit at some point in their career.

Now, as provisions of the Affordable Care Act (ACA) ripple through our industry, we think E&O claims are likely to increase. Employers face an entirely new set of legal and tax consequences in the benefits area and who do they look to for advice? You, their trusted benefits advisor. How can you protect yourself from claims and if there is a claim how should you handle it?

Here are three steps to protect yourself and handle claims:

Review your E&O policy with your trusted commercial insurance advisor. Ensure the coverage amounts are adequate for a business of your size and make certain that your policy covers you from ACA-related claims (no exclusions). If it does not, consider changing policies.

Review and if necessary, modify how you advise prospects and clients. While a good E&O policy will protect you from a wide range of claims related to your advisory services, with all the new ACA questions from individuals and employers, you may be tempted to offer advice that is best left to a tax or legal professional. Be careful not to cross that line.

Should you be subject to an E&O claim or become aware of legal action against you, read this helpful “Do’s and Don’ts” article recently published in Insurance Business America.

Following these three steps will put you in a much better position to handle an E&O claim, should it arise. At Claremont, we recently reviewed our E&O policy with our commercial insurance advisor and confirmed that our policy covers claims related to ACA. If you would like to have your policy reviewed, we would be pleased to recommend our advisor. For assistance, call us at 800.696.4543.

]]>http://www.claremontcompanies.com/3-steps-to-protect-yourself-from-an-errors-and-omissions-claim/feed/0SVAHU April 23 Innovators Meetinghttp://www.claremontcompanies.com/svahu-special-event-april-23-2015/
http://www.claremontcompanies.com/svahu-special-event-april-23-2015/#commentsThu, 12 Mar 2015 06:55:18 +0000http://www.claremontcompanies.com/?p=5783The Silicon Valley Association of Health Underwriters April meeting will feature presentations on the evolving role of the broker, exhibits by market innovators, …read more]]>The Silicon Valley Association of Health Underwriters April meeting will feature presentations on the evolving role of the broker, exhibits by market innovators, and a conversation with Parker Conrad, Co-Founder and CEO of Zenefits.

Don’t miss this valuable opportunity to learn about industry changes, the impact on your business, and how to get ahead of your competition. Register now.

Questions?
Contact the Silicon Valley Association of Health Underwriters at 916.505.7425 or svahuinfo@gmail.com.

]]>http://www.claremontcompanies.com/svahu-special-event-april-23-2015/feed/0Agents With Incomplete Training Will Be Decertifiedhttp://www.claremontcompanies.com/agents-with-incomplete-training-will-be-decertified/
http://www.claremontcompanies.com/agents-with-incomplete-training-will-be-decertified/#commentsThu, 12 Mar 2015 06:06:59 +0000http://www.claremontcompanies.com/?p=5782Agents who have not completed the mandatory Voter Registration Training by the March 1, 2015 deadline will be decertified in the first week …read more]]>Agents who have not completed the mandatory Voter Registration Training by the March 1, 2015 deadline will be decertified in the first week of April. Decertified agents will not be allowed to provide enrollment assistance to consumers or businesses applying for health coverage through Covered California.

To maintain your certification with Covered California, you must complete the training now. Contact the Agent Service Center at 877.453.9198 for the training materials.

]]>http://www.claremontcompanies.com/agents-with-incomplete-training-will-be-decertified/feed/0UnitedHealthcare Webinar: Small Business Plan Updateshttp://www.claremontcompanies.com/webinar-2015-small-business-updates/
http://www.claremontcompanies.com/webinar-2015-small-business-updates/#commentsMon, 09 Mar 2015 19:18:26 +0000http://www.claremontcompanies.com/?p=5779Learn about the exciting changes at UnitedHealthcare that can help you develop strategies to acquire new clients and better serve your existing clients.

Learn about the exciting changes at UnitedHealthcare that can help you develop strategies to acquire new clients and better serve your existing clients.

To give you and your staff a competitive advantage, UnitedHealthcare will be introducing powerful new products and sharing essential information during an exclusive live webinar. Attend this webinar and earn a complimentary coupon redeemable for one CE class (worth up to 12 credits).

]]>http://www.claremontcompanies.com/webinar-2015-small-business-updates/feed/0UnitedHealthcare Webinar: Small Business Plan Updateshttp://www.claremontcompanies.com/unitedhealthcare-webinar-2015-small-business-updates/
http://www.claremontcompanies.com/unitedhealthcare-webinar-2015-small-business-updates/#commentsTue, 10 Mar 2015 06:17:31 +0000http://www.claremontcompanies.com/?p=5780Learn about the exciting changes at UnitedHealthcare that can help you develop strategies to acquire new clients and better serve your existing clients.

Learn about the exciting changes at UnitedHealthcare that can help you develop strategies to acquire new clients and better serve your existing clients.

To give you and your staff a competitive advantage, UnitedHealthcare will be introducing powerful new products and sharing essential information during an exclusive live webinar. Attend this webinar and earn a complimentary coupon redeemable for one CE class (worth up to 12 credits).

]]>http://www.claremontcompanies.com/unitedhealthcare-webinar-2015-small-business-updates/feed/02015 Blue Shield Sales Brochure for 1-50 Groupshttp://www.claremontcompanies.com/2015-blue-shield-sales-brochure-for-1-50-groups/
http://www.claremontcompanies.com/2015-blue-shield-sales-brochure-for-1-50-groups/#commentsFri, 27 Feb 2015 22:48:13 +0000http://www.claremontcompanies.com/?p=5776This sales brochure for brokers describes the PPO, HSA and HMO plan options for small businesses with 1-50 employees. This brochure includes Off …read more]]>This sales brochure for brokers describes the PPO, HSA and HMO plan options for small businesses with 1-50 employees. This brochure includes Off SHOP and Mirror Small Business packages, and will be valid through June 30, 2015. If you have any questions about Blue Shield plans or group qualifications, call our team at 800-696-4542 for assistance.

Covered California is offering a Special Enrollment Period (SEP) for consumers to minimize their tax penalty.

From February 23 until April 30, 2015, eligible consumers who did not know or understand there was a tax penalty for being uninsured in 2014, or who learned they may face a penalty for 2015, will be able to apply for health coverage.

A new Qualifying Life Event (QLE) called “Informed of Tax Penalty Risk” has been added to the CoveredCA.com drop down menu. Consumers can select this option when applying for coverage at CoveredCA.com. To be eligible, consumers must attest that they became aware of the tax penalty after the 2015 Open Enrollment Period closed.

Tax penalties will increase significantly in 2015.
Those who can afford insurance but choose not to buy it will be subject to paying $325 per adult in a household or 2 percent of their income, whichever is greater. Learn more.

IRS tax penalties for those uninsured in 2014:

Single person earning $40,000 a year will pay nearly $300

Family of four earning $70,000 a year will pay nearly $500

IRS tax penalties for those uninsured in 2015:

Single person earning $40,000 a year will pay nearly $600

Family of four earning $70,000 a year will pay nearly $1,000

In addition to the “Informed of Tax Penalty Risk” QLE, Californians who have a life-changing event, for example: having a baby, getting married, losing their health care coverage because they have changed jobs or are moving to another area, can qualify for a SEP. They can sign up for coverage within 60 days of the QLE.

]]>http://www.claremontcompanies.com/informed-of-tax-penalty-risk-special-enrollment-opportunity/feed/0New Mobile Website and Mobile Apps Launchedhttp://www.claremontcompanies.com/new-mobile-website-and-mobile-apps-launched-3/
http://www.claremontcompanies.com/new-mobile-website-and-mobile-apps-launched-3/#commentsFri, 27 Feb 2015 20:33:02 +0000http://www.claremontcompanies.com/?p=5772Your small business members can now get their health plan information easier and faster anytime, anywhere, and from any device, with Blue Shield’s …read more]]>Your small business members can now get their health plan information easier and faster anytime, anywhere, and from any device, with Blue Shield’s enhanced mobile website and new mobile apps.

New features include access to:

Delegated members’ claim information

Copayment and deductible year-to-date totals

Expanded benefit details

Password and username reset/change

Most information in Spanish

Visit the new mobile website by entering blueshieldca.com in your mobile device’s browser.

]]>http://www.claremontcompanies.com/new-mobile-website-and-mobile-apps-launched-3/feed/0New Mobile Website and Mobile Apps Launchedhttp://www.claremontcompanies.com/new-mobile-website-and-mobile-apps-launched/
http://www.claremontcompanies.com/new-mobile-website-and-mobile-apps-launched/#commentsFri, 27 Feb 2015 02:54:36 +0000http://www.claremontcompanies.com/?p=5765Your small business members can now get their health plan information easier and faster anytime, anywhere, and from any device, with Blue Shield’s …read more]]>Your small business members can now get their health plan information easier and faster anytime, anywhere, and from any device, with Blue Shield’s enhanced mobile website and new mobile apps.

New features include access to:

Delegated members’ claim information

Copayment and deductible year-to-date totals

Expanded benefit details

Password and username reset/change

Most information in Spanish

Visit the new mobile website by entering blueshieldca.com in your mobile device’s browser.

]]>http://www.claremontcompanies.com/new-mobile-website-and-mobile-apps-launched/feed/0The Anthem Cyber Attack – How it May Impact Your Clientshttp://www.claremontcompanies.com/anthem-cyber-attack-may-impact-clients-2/
http://www.claremontcompanies.com/anthem-cyber-attack-may-impact-clients-2/#commentsThu, 19 Feb 2015 21:04:01 +0000http://www.claremontcompanies.com/?p=5758We want to inform you that records of some Blue Shield of California members may have been compromised.

Call Anthem’s hotline at 877.263.7995, and look for Anthem’s official notification by U.S. postal service, if their information was accessed during this cyber attack.

Be cautious of any attempts to obtain plan coverage information or personal data such as: credit card, social security, date-of-birth, etc. There have been reports of phishing schemes designed to steal member information by attempting to charge fees and offer unauthorized identity theft protection.
– Do not provide any information or respond to an email or phone call.
– Do not click on any links or open any attachments in an email.
– Always go directly to AnthemFacts.com.

Anthem is providing two years of free identity protection and credit monitoring services to all current or former members (from 2004 on). Those impacted will receive notification from Anthem, by U.S. postal service, in the coming weeks.

To learn more visit AnthemFacts.com/faqs or call 877.263.7995 for assistance. We will provide updates as they become available.

]]>http://www.claremontcompanies.com/anthem-cyber-attack-may-impact-clients-2/feed/0The Anthem Cyber Attack – How it May Impact Your Clientshttp://www.claremontcompanies.com/anthem-cyber-attack-may-impact-clients/
http://www.claremontcompanies.com/anthem-cyber-attack-may-impact-clients/#commentsThu, 19 Feb 2015 21:03:11 +0000http://www.claremontcompanies.com/?p=5759We want to inform you that records of some Blue Shield of California members may have been compromised.

Call Anthem’s hotline at 877.263.7995, and look for Anthem’s official notification by U.S. postal service, if their information was accessed during this cyber attack.

Be cautious of any attempts to obtain plan coverage information or personal data such as: credit card, social security, date-of-birth, etc. There have been reports of phishing schemes designed to steal member information by attempting to charge fees and offer unauthorized identity theft protection.
– Do not provide any information or respond to an email or phone call.
– Do not click on any links or open any attachments in an email.
– Always go directly to AnthemFacts.com.

Anthem is providing two years of free identity protection and credit monitoring services to all current or former members (from 2004 on). Those impacted will receive notification from Anthem, by U.S. postal service, in the coming weeks.

To learn more visit AnthemFacts.com/faqs or call 877.263.7995 for assistance. We will provide updates as they become available.

]]>http://www.claremontcompanies.com/anthem-cyber-attack-may-impact-clients/feed/0Possible Service Disruption for Health Net Membershttp://www.claremontcompanies.com/possible-service-disruption-health-net-ppo-ifp-plans/
http://www.claremontcompanies.com/possible-service-disruption-health-net-ppo-ifp-plans/#commentsTue, 17 Feb 2015 04:52:43 +0000http://www.claremontcompanies.com/?p=5755A network change, that affects Health Net Individual and Family Plan (IFP) members with EPO coverage (which has a limited or exclusive network), …read more]]>A network change, that affects Health Net Individual and Family Plan (IFP) members with EPO coverage (which has a limited or exclusive network), has created confusion for providers, and in some cases a service disruption for all Health Net members in Covered California. This network change does not apply to members enrolled in a Health Net PPO Small Business (SHOP) Plan (which provides PPO coverage for all four metal tier plans).

This confusion may result in inconvenience for affected SHOP Health Net PPO Plan enrollees, who are permitted to access any physician under their PPO plan.

To eliminate your clients’ confusion and minimize possible service disruptions for their members, follow these three simple steps:

Use our email template to notify your Health Net member groups about the confusion.

Distribute our handout entitled “Explanation of Health Net ID Cards from Covered California”, to clarify the Health Net PPO and IFP EPO Plans in Covered California.
• Brand this version of the handout with your logo and contact information.
• Instruct your clients to have all their members, who participate in Health Net coverage, bring a printed copy to their physician appointments.

Blue Shield announced January 30 that a new two-year agreement with Sutter Health was signed, …read more]]>

Blue Shield and Sutter Health Signed a New Contract

Blue Shield announced January 30 that a new two-year agreement with Sutter Health was signed, effective February 1, 2015. This means that Sutter hospitals and doctors will continue to be participating providers in the Blue Shield network.

Blue Shield issued a press release regarding this news. In addition, they will also be communicating this announcement to employer groups located in the Sutter Health regions (central and northern California) and to impacted Blue Shield members.

Blue Shield announced January 30 that a new two-year agreement with Sutter Health was signed, …read more]]>

Blue Shield and Sutter Health Signed a New Contract

Blue Shield announced January 30 that a new two-year agreement with Sutter Health was signed, effective February 1, 2015. This means that Sutter hospitals and doctors will continue to be participating providers in the Blue Shield network.

Blue Shield issued a press release regarding this news. In addition, they will also be communicating this announcement to employer groups located in the Sutter Health regions (central and northern California) and to impacted Blue Shield members.

]]>http://www.claremontcompanies.com/blue-shield-terminates-sutter-health-contract-2/feed/0Specialty Plans Score Highest for Customer Satisfaction in J.D. Power Reportshttp://www.claremontcompanies.com/unitedhealthcare-specialty-plans-score-highest-customer-satisfaction-j-d-power-reports/
http://www.claremontcompanies.com/unitedhealthcare-specialty-plans-score-highest-customer-satisfaction-j-d-power-reports/#commentsFri, 30 Jan 2015 20:31:53 +0000http://www.claremontcompanies.com/?p=5738Vision and dental plans from UnitedHealthcare rank highest in customer satisfaction nationwide, according to J.D. Power’s 2014 Vision Plan and 2014 Dental Plan …read more]]>Vision and dental plans from UnitedHealthcare rank highest in customer satisfaction nationwide, according to J.D. Power’s 2014 Vision Plan and 2014 Dental Plan Satisfaction Reports. This is the second consecutive year UHC has won in the vision category.

The reports are based on responses from more than 5,600 plan participants and measure member satisfaction based on coverage, cost, communications, customer service and reimbursement.

Among the member-friendly features of UnitedHealthcare’s Vision and Dental plans are low out-of-pocket costs, easy-to-use web resources and integrated benefit administration.

Your groups can purchase these outstanding specialty benefits a la carte at very competitive rates. They can enjoy even greater value if they bundle them with a UnitedHealthcare medical plan.

To learn how you and your clients can benefit from UnitedHealthcare’s highly-rated low-cost medical and specialty plans, contact us today at 800.696.4543 or info@claremontcompanies.com.

]]>http://www.claremontcompanies.com/unitedhealthcare-specialty-plans-score-highest-customer-satisfaction-j-d-power-reports/feed/0Specialty Plans Score Highest for Customer Satisfaction in J.D. Power Reportshttp://www.claremontcompanies.com/unitedhealthcare-specialty-plans-score-highest-customer-satisfaction-j-d-power-reports-2/
http://www.claremontcompanies.com/unitedhealthcare-specialty-plans-score-highest-customer-satisfaction-j-d-power-reports-2/#commentsFri, 30 Jan 2015 20:32:18 +0000http://www.claremontcompanies.com/?p=5737Vision and dental plans from UnitedHealthcare rank highest in customer satisfaction nationwide, according to J.D. Power’s 2014 Vision Plan and 2014 Dental Plan …read more]]>Vision and dental plans from UnitedHealthcare rank highest in customer satisfaction nationwide, according to J.D. Power’s 2014 Vision Plan and 2014 Dental Plan Satisfaction Reports. This is the second consecutive year UHC has won in the vision category.

The reports are based on responses from more than 5,600 plan participants and measure member satisfaction based on coverage, cost, communications, customer service and reimbursement.

Among the member-friendly features of UnitedHealthcare’s Vision and Dental plans are low out-of-pocket costs, easy-to-use web resources and integrated benefit administration.

Your groups can purchase these outstanding specialty benefits a la carte at very competitive rates. They can enjoy even greater value if they bundle them with a UnitedHealthcare medical plan.

To learn how you and your clients can benefit from UnitedHealthcare’s highly-rated low-cost medical and specialty plans, contact us today at 800.696.4543 or info@claremontcompanies.com.

]]>http://www.claremontcompanies.com/unitedhealthcare-specialty-plans-score-highest-customer-satisfaction-j-d-power-reports-2/feed/0IRS Tax Form 1095-A: Recorded Webinar + Slideshttp://www.claremontcompanies.com/irs-tax-form-1095-recorded-webinar-slides/
http://www.claremontcompanies.com/irs-tax-form-1095-recorded-webinar-slides/#commentsFri, 16 Jan 2015 19:17:28 +0000http://www.claremontcompanies.com/?p=5698Covered California consumers will begin to receive the new IRS Form 1095-A to help reconcile the 2014 Advanced Premium Tax Credit (APTC) they …read more]]>Covered California consumers will begin to receive the new IRS Form 1095-A to help reconcile the 2014 Advanced Premium Tax Credit (APTC) they received vs the actual Premium Tax Credit (PTC) they were eligible for in 2014. A large percentage of consumers who received insurance subsidies may have received tax credits beyond the allowable amounts.

Be prepared to advise your clients about the mandates, penalties, and process by viewing the:

Covered California steps up messaging that tax penalties are going up for 2015 for uninsured Californians.

“It’s important that consumers understand now that the cost of remaining uninsured is rising,” Covered California Executive Director Peter V. Lee said. “This year, a family of four earning $70,000 a year could pay close to $1,000 in their taxes if they remain uninsured in 2015.”

Lee said the penalty messaging will be stepped up through service channels, in social media and in paid advertising in the remaining weeks of open enrollment. Materials stress not only the financial consequences, but also the health consequences of remaining uninsured.

]]>http://www.claremontcompanies.com/tax-penalties-going-up-in-2015-for-uninsured/feed/0Win free telemarketing from SHOPhttp://www.claremontcompanies.com/win-free-telemarketing-shop/
http://www.claremontcompanies.com/win-free-telemarketing-shop/#commentsThu, 15 Jan 2015 00:03:55 +0000http://www.claremontcompanies.com/?p=5697You don’t want to miss this new Covered California promotion! From February through April 2015, the Certified Insurance Agent that quotes the most …read more]]>You don’t want to miss this new Covered California promotion! From February through April 2015, the Certified Insurance Agent that quotes the most lives through the Small Business Health Options Program (SHOP) will receive 100 hours of free telemarketing support to assist them in generating interest from small business owners. This telemarketing support has an estimated value of $2,800 and can produce up to 50 new leads per month!

Second and third place winners will also be rewarded – with entry into the SHOP Lead Management System. This is marketing support you won’t find anywhere else. See the SHOP to Win flyer to learn more!

]]>http://www.claremontcompanies.com/win-free-telemarketing-shop/feed/0http://www.claremontcompanies.com/5363/
http://www.claremontcompanies.com/5363/#commentsSat, 20 Dec 2014 01:15:26 +0000http://www.claremontcompanies.com/?p=5363Available starting January 1, 2015 to current Choice Builder customers. Not available to new groups.

Current Choice Builder can sign up at www.choicebuilder.com. Simply click on “Make a Payment” to get started.

]]>http://www.claremontcompanies.com/5363/feed/0Guide to Blue Shield December 2014 Renewalshttp://www.claremontcompanies.com/guide-blue-shield-december-2014-renewals/
http://www.claremontcompanies.com/guide-blue-shield-december-2014-renewals/#commentsThu, 11 Dec 2014 21:33:12 +0000http://www.claremontcompanies.com/?p=5314December 2014 renewal deadlines are almost here. Have you processed your Blue Shield client renewals online? Has the group submitted member level change …read more]]>December 2014 renewal deadlines are almost here. Have you processed your Blue Shield client renewals online? Has the group submitted member level change forms needed on paper? Not sure? Before time runs out, download our simple guide to learn:

• What you and your groups need to do
• When you need to take action to meet the 12/31 deadline
• How to promptly take action online or via paper forms

If you need support with your Blue Shield renewals, contact our experienced team for assistance.

]]>http://www.claremontcompanies.com/guide-blue-shield-december-2014-renewals/feed/0Broker commissions unchanged for small business, Revised SOBs, Dental plan updateshttp://www.claremontcompanies.com/small-group-broker-commissions-remain-stable-revised-sobs-dental-plan-updates/
http://www.claremontcompanies.com/small-group-broker-commissions-remain-stable-revised-sobs-dental-plan-updates/#commentsTue, 02 Dec 2014 20:36:34 +0000http://www.claremontcompanies.com?p=5279Broker Commissions in 2015 will remain stable for small group plans. The new 2015 commission schedule is now available on Producer Connection.

Broker Commissions in 2015 will remain stable for small group plans. The new 2015 commission schedule is now available on Producer Connection.

Revised Summary of Benefits: When originally published, there were errors in some of the summary of benefits (SOBs). SOBs that have been corrected for the following small business health plans listed below and are posted on Producer Connection. Spanish versions of the SOBs are also available.

Gold Access + HMO – $30 OffEx

Gold Local Access + HMO – $30 OffEx

Gold Trio ACO HMO – $30 OffEx

Silver Access + HMO – $55 OffEx

Silver Local Access + HMO – $55

Silver Trio ACO HMO – %55 OffEx

Dental Plans: The latest dental benefit summaries are available to download. Family dental plans are scheduled for release in July 2015.

]]>http://www.claremontcompanies.com/small-group-broker-commissions-remain-stable-revised-sobs-dental-plan-updates/feed/0Blue Shield offers Bonus for SeeChange clientshttp://www.claremontcompanies.com/blue-shield-offers-bonus-seechange-clients/
http://www.claremontcompanies.com/blue-shield-offers-bonus-seechange-clients/#commentsTue, 25 Nov 2014 22:29:03 +0000http://www.claremontcompanies.com?p=5265SeeChange clients should move coverage by December 31st to avoid disruption in continuity of care. Blue Shield is offering a bonus to compensate …read more]]>SeeChange clients should move coverage by December 31st to avoid disruption in continuity of care. Blue Shield is offering a bonus to compensate brokers for the time to help clients through this transition.

Earn $50 per enrolled employee, up to $2,500 on top of your standard commission. See more details on this limited time offer.

]]>http://www.claremontcompanies.com/blue-shield-offers-bonus-seechange-clients/feed/0Impermissible Reimbursement Arrangementshttp://www.claremontcompanies.com/impermissible-reimbursement-arrangements/
http://www.claremontcompanies.com/impermissible-reimbursement-arrangements/#commentsTue, 18 Nov 2014 18:53:57 +0000http://www.claremontcompanies.com?p=5241The Department of Labor (DOL), Health and Human Services (HHS), and Treasury issued a FAQ dated November 6, 2014 reinforcing that any arrangement …read more]]>The Department of Labor (DOL), Health and Human Services (HHS), and Treasury issued a FAQ dated November 6, 2014 reinforcing that any arrangement for reimbursement or payment of premiums for an individual market policy for active employees is impermissible. Health Reimbursement Arrangements (HRAs) and other similar defined contribution arrangements for active employees are also impermissible unless they are “integrated”[1] with an employer’s group health plan or the reimbursement under such arrangements are limited to retirees or certain excepted benefits[2]. Vendors, such as TASC and Zane Benefits, market products to employers wherein employers set-up a Code section 105 reimbursement plan that allows employees to purchase individual insurance policies, and access premium tax credits for Marketplace coverage, if eligible. However, in the FAQs, the DOL, HHS, and Treasury stressed that these arrangements are also impermissible.

In a prior guidance issued on September 13, 2013 (Notice 2013-54), the DOL and Treasury explained why these arrangements are impermissible. Reimbursement arrangements, employer payment plans, and defined contribution reimbursement arrangements generally are considered to be group health plans and are thus subject to rules applicable to group health plans. The Affordable Care Act market reforms, specifically the annual dollar limit prohibition and the preventive services requirements, apply to group health plans. Under the annual dollar limit prohibition, a group health plan may not establish any annual limit on the dollar amount of essential health benefits. The preventive services requirement provides that non-grandfathered group health plans are required to provide certain preventive services without cost-sharing. Reimbursement arrangements, employer payment plans, and defined contribution reimbursement arrangements will fail to comply with the annual dollar limit prohibition, because these arrangements/plans are considered to impose an annual limit up to the cost of the individual market coverage purchased through the arrangement. These arrangements/plans will also fail to comply with the preventive services requirements, because they do not provide preventive services without cost-sharing in all instances.

Impermissible arrangements maintained by private employers will be subject to an excise tax equal to $100 per day ($36,500 per year), per affected beneficiary, with a cap of $500,000 for non-willful violations. They may also be subject to suits by affected participants and beneficiaries to enforce their rights under ERISA. An employer’s impermissible arrangement may also negatively impact their employees. Potential employee consequences could include having to repay subsidies or re-file income taxes. With new rules in place for health and welfare plans, the government is reviewing health and group plans for compliance at an increasingly frequent rate. These rules are already in effect, they were effective for plan years beginning on or after January 1, 2014.

Make sure to advise your prospects and clients.
If they have one of these arrangements in place, contact us at 800.696.4543 or info@claremontcompanies.com for a solution to address their risk.

Appendix
[1]

* The term “medical care” means amounts paid–
(A) for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body,
(B) for transportation primarily for and essential to medical care referred to in subparagraph (A),
(C) for qualified long-term care services, or
(D) for insurance (including amounts paid as premiums under part B of title XVIII of the Social Security Act, relating to supplementary medical insurance for the aged) covering medical care referred to in subparagraphs (A) and (B) or for any qualified long-term care insurance contract.

The following are excepted benefits if the benefits are provided under a separate policy, certificate, or contract:(I) Limited scope dental or vision benefits
(J) Benefits for long-term care, nursing home care, home health care, community-based care
(K) Coverage only for a specified disease or illness
(L) Hospital indemnity or other fixed indemnity insurance
(M) Medicare supplemental health insurance, and similar supplemental coverage provided to coverage under a group health plan

UnitedHealthcare partners with Claremont to help brokers meet the unique healthcare needs of California businesses with fewer than 100 employees.

Now you can benefit from Claremont’s unrivaled broker-focused service solutions, while your small business clients and their employees can take advantage of UnitedHealthcare’s top rated affordable suite of health benefit programs, including HMO, PPO, HSA, dental, vision, and life insurance.

To learn how you and your small business clients can benefit from UnitedHealthcare’s medical and specialty plans, contact us at 800.696.4543 or info@claremontcompanies.com.

UnitedHealthcare partners with Claremont to help brokers meet the unique healthcare needs of California businesses with fewer than 100 employees.

Now you can benefit from Claremont’s unrivaled broker-focused service solutions, while your small business clients and their employees can take advantage of UnitedHealthcare’s top rated affordable suite of health benefit programs, including HMO, PPO, HSA, dental, vision, and life insurance.

To learn how you and your small business clients can benefit from UnitedHealthcare’s medical and specialty plans, contact us at 800.696.4543 or info@claremontcompanies.com.

]]>http://www.claremontcompanies.com/unitedhealthcare-partners-claremont/feed/0Health Net PPO Plans From SHOPhttp://www.claremontcompanies.com/health-net-ppo-plans-shop/
http://www.claremontcompanies.com/health-net-ppo-plans-shop/#commentsMon, 10 Nov 2014 08:11:24 +0000http://www.claremontcompanies.com?p=5198Covered California sent a letter to Health Net Life Insurance PPO members and groups telling them that Health Net will not offer their …read more]]>Covered California sent a letter to Health Net Life Insurance PPO members and groups telling them that Health Net will not offer their plan in 2015. This is true only for individuals and families who buy through Covered California. Health Net will continue to offer PPO insurance plans off-exchange and for small business groups. Learn more.
]]>http://www.claremontcompanies.com/health-net-ppo-plans-shop/feed/0SHOP January Renewals Releasedhttp://www.claremontcompanies.com/shop-january-renewals-released/
http://www.claremontcompanies.com/shop-january-renewals-released/#commentsSun, 09 Nov 2014 00:29:55 +0000http://www.claremontcompanies.com?p=5217January 2015 renewals are in the mail to employers, brokers and general agents. This is the first open enrollment for Covered California.

Full service quotes provided by Claremont:
• Include the “optional rider” to ensure pediatric dental is included in your quote.

Claremont elected the PPO plan to reflect the highest cost and ensure the coverage is included for applicable members. Should the group enroll, they would have the option to elect the HMO Pediatric plan, if they live in California.

Self-service quotes by brokers:
• Should follow the same rule and add the “optional rider.”

To add the “optional rider” follow these simple steps within PRISM:
1. After selecting your medical plans for quoting here:

2. Elect the rider feature on the confirmation page.
3. Select the Children Dental PPO for Small Business and click Update All Plans.

]]>http://www.claremontcompanies.com/2015-pediatric-dental-plans/feed/0It’s Now Easier To Enroll New Groupshttp://www.claremontcompanies.com/now-easier-enroll-new-groups/
http://www.claremontcompanies.com/now-easier-enroll-new-groups/#commentsSat, 08 Nov 2014 21:56:51 +0000http://www.claremontcompanies.com?p=5207Healthcare reform law requires carriers to accept all small business customers, even if they don’t meet minimum participation or contribution requirements, during an …read more]]>Healthcare reform law requires carriers to accept all small business customers, even if they don’t meet minimum participation or contribution requirements, during an annual open enrollment period from November 15 through December 31.

Blue Shield is expanding their special open enrollment to November 1 – December 31, for new small group business. Groups that did not qualify earlier can take advantage of this opportunity to enroll for January 1, 2015 coverage.

Extended Relaxed Participation Requirementpromotion through March 1, 2015.
Groups only need 25% or more of the total number of eligible employees to enroll in a Blue Shield health plan, with no fewer than five employees. Learn more.

December 8, 2014 – changes for January renewals can be done online through the Blue Shield Renewal Center. Group-level changes (grandmother or ACA plans, plus waiting period selection) and member-level changes will be available.

Rate update for Q1 2015
Medical plans will average a modest rate increase of less than 2%; Specialty Benefits plans will have a rate pass. To learn more, visit Blue Shield’s Producer Connection.

Note: dental and vision rates are not included in the January packets. Learn more.

New plan names
Blue Shield has changed the small business plan names. The new names will make it easier to understand the level of benefits each plan offers. Visit Blue Shield’s Producer Connection for more information.

An HMO plan example: Ultimate Full HMO for Small Business $25 is now Platinum Access+ HMO $25 OffEx.

A PPO plan example: Ultimate Full PPO for Small Business 0 is now Platinum Full PPO 0 OffEx.

Rating by employer locationFor new and renewing small groups as of January 2015, Blue Shield will issue rates for all enrollees of a group based on the employer’s primary location in California.

Specialty products – moving back to tier-level ratingDental and vision plan rates will be based on employee tiers, not a per member rate.

]]>http://www.claremontcompanies.com/2015-plans/feed/0Online Certification Training Available Mid-Octoberhttp://www.claremontcompanies.com/online-certification-training-available-mid-october/
http://www.claremontcompanies.com/online-certification-training-available-mid-october/#commentsThu, 30 Oct 2014 15:42:22 +0000http://www.claremontcompanies.com?p=5174Covered California’s entire certification and training will be available online mid-October, in the Learning Management System (LMS). The updated Computer Based Training (CBT) …read more]]>Covered California’s entire certification and training will be available online mid-October, in the Learning Management System (LMS). The updated Computer Based Training (CBT) Courses will take the place of in-person, instructor led classes. To sell Covered California products, licensed agents must complete the training and certification process.

To avoid delays in accessing your training materials:

Ensure your LMS log-in is set up or reactivated.

To reactivate, send an email to agents@covered.ca.gov, subject line “REINSTATE IN LMS” and include your name, license number, email address, and telephone number.

To reset your username or password, log-in to the LMS and use the “Forgot your login ID?” and “Forgot your password?” features, or call 877.453.9198.